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The economic burden of child maltreatment in the United States and implications for prevention
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OBJECTIVES: To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. METHODS: This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used attributable costs whenever possible. For those categories that attributable cost data were not available, costs were estimated as the product of incremental effect of child maltreatment on a specific outcome multiplied by the estimated cost associated with that outcome. The estimate of the aggregate lifetime cost of child maltreatment in 2008 was obtained by multiplying per-victim lifetime cost estimates by the estimated cases of new child maltreatment in 2008. RESULTS: The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion. CONCLUSIONS: Compared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment.
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“These consequences are far-reaching into families and communities, with significant costs for institutions in terms of primary and rehabilitative health care, education and welfare assistance, child protection, and justice system costs (Fang 2012).”
From School-based education programmes for the prevention of child sexual abuse (2015) · cites this paper as Fang 2012
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EVALUATION OF ALL BABIES CRY, A SECOND GENERATION UNIVERSAL ABUSIVE HEAD TRAUMA PREVENTION PROGRAM
Morrill, A. C., McElaney, L., Peixotto, B., VanVleet, M. W., & Sege, R. D. (2015) · Journal of Community Psychology · doi:10.1002/jcop.21679 · Cited by 12
Child Maltreatment: Daunting and Universally Prevalent
Tarantola, D. J. M. (2018) · American Journal of Public Health · doi:10.2105/ajph.2018.304637 · Cited by 12
Botha, E., Helminen, M., Kaunonen, M., Lubbe, W., & Joronen, K. (2020) · Journal of Perinatal & Neonatal Nursing · doi:10.1097/jpn.0000000000000510 · Cited by 11
“For all these reasons, early prevention is critical.(8) The aim of this study was to evaluate the effects of a behavioral infant calming intervention to support mothers’ parenting self-efficacy (PSE) and parenting satisfaction (PS).”
BackgroundA Public Health Response to Data Interoperability to Prevent Child Maltreatment
Nguyen, L. H. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.302143 · Cited by 11
Luo, J., Ma, Y., Zhan, H.-W., Jia, W.-H., Zhang, J.-R., Xie, S.-Y., Yu, S.-Y., Hou, S.-L., Bi, X., & Wang, X. (2024) · BMC Public Health · doi:10.1186/s12889-024-19239-6 · Cited by 11
“ACEs also represent a significant healthcare burden, with the total annual cost of ACEs being over $1329 billion in Europe and North America, and the lifetime economic burden of ACE abuse alone being $585 billion [2, 5].”
BackgroundRaghavan, R., Brown, D. S., Allaire, B. T., Garfield, L. D., Ross, R. E., & Snowden, L. R. (2014) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2014.02.013 · Cited by 11
Self-citationRethinking Risk and Resilience in Childhood and Child Maltreatment
Titterton, M., & Taylor, J. S. (2017) · The British Journal of Social Work · doi:10.1093/bjsw/bcx117 · Cited by 11
“Some researchers have drawn attention to the economic costs of abuse over time (e.g. Xiangming et al., 2012), something to be flagged up to governments.”
BackgroundCameranesi, M., Shooshtari, S., & Piotrowski, C. C. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105453 · Cited by 12
Alsubaie, M. A., Alkhalifah, H. A., Ali, A. H., Bahabri, M. A., Alharbi, B. A., & Alfakeh, S. A. (2022) · Cureus · doi:10.7759/cureus.25791 · Cited by 11
“Indeed, the lifetime expenses of a person abused as a child are estimated to be approximately $210,012 [6].”
BackgroundMathews, B. (2015) · Springer eBooks · doi:10.1007/978-81-322-2425-9_21 · Cited by 11
“The economic costs to survivors, families and communities are vast (Fang et al., 2012; Fromm 2001; Taylor et al., 2008).”
BackgroundSimonich, H. K., Wonderlich, S. A., Erickson, A. L., Myers, T. C., Hoesel, J., Wagner, S., & Engel, K. E. (2015) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-015-9305-4 · Cited by 11
“Center for Disease Control estimated that the cost of child maltreatment in 1 year totals $124 billion and is more costly on an annual basis than two other leading health concerns, stroke and type 2 diabetes (Xiangming et al. 2012).”
BackgroundDwelling in Suffering: Barriers to Men's Healing from Childhood Maltreatment
Willis, D. G., LaCoursiere-Zucchero, T., DeSanto‐Madeya, S., Ross, R. J. M., Leone, D., Kaubris, S., Moll, K., Kuhlow, E., & Easton, S. D. (2014) · Issues in Mental Health Nursing · doi:10.3109/01612840.2013.856972 · Cited by 10
Adhia, A., Potter, S. J., Stapleton, J., ZUCKERMAN, B. S., Phan, N., & Bair‐Merritt, M. H. (2017) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2016.1264527 · Cited by 11
“Of the estimated $210,000 lifetime cost per child abuse survivor, productivity losses make up nearly 70% of that burden (Fang et al., 2012).”
BackgroundDo State TANF Policies Affect Child Abuse and Neglect
Ginther, D. K. (2017) · Cited by 11
Psychobiological Consequences of Child Maltreatment
Heim, C. C. (2018) · Child maltreatment solutions network · doi:10.1007/978-3-319-72589-5_2 · Cited by 11
Patton, D., Liu, Q., Adelson, J. D., & Lucenko, B. A. (2018) · Health Services Research · doi:10.1111/1475-6773.13052 · Cited by 10
Outcomes from early child maltreatment prevention program in child protective services
Millett, L. S. (2019) · Children and Youth Services Review · doi:10.1016/j.childyouth.2019.04.009 · Cited by 11
A Multidisciplinary Child Protection Team Improves the Care of Nonaccidental Trauma Patients
Draus, J. M. (2017) · The American Surgeon · doi:10.1177/000313481708300521 · Cited by 11
Metadata
- Authors
- Fang, X., Brown, D. S., Florence, C. S., & Mercy, J. A.
- Affiliations
- Centers for Disease Control and Prevention (US)
- RTI International (US)
- Corresponding author
- Fang, Xiangming
- Venue
- Child Abuse & Neglect
- Publisher
- Elsevier BV
- Published
- 2012-02
- Volume
- 36
- Issue
- 2
- Pages
- 156-165
- ISSN
- 0145-2134 (ISSN-L)
- PMC
- PMC3776454
- OpenAlex
- W2167783241
- Cited by
- 1,122
- References
- 62
- Citations by year
- 2026: 30 · 2025: 41 · 2024: 47 · 2023: 65 · 2022: 95 · 2021: 75 · 2020: 111 · 2019: 91 · 2018: 111 · 2017: 112 · 2016: 101 · 2015: 100 · 2014: 69 · 2013: 52 · 2012: 16
- FWCI
- 86.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Child Abuse & Neglect (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Centers for Disease Control and Prevention (200-2008-M-28149)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
- Keywords
- child abuse, economic burden, lifetime costs, child abuse prevention, productivity loss, criminal justice costs, special education costs, cost estimation
- MeSH terms
- Adolescent, Adult, Child, Child Abuse, Child, Preschool, Costs and Cost Analysis, Female, Humans, Infant, Male, Middle Aged, United States, Health Care Costs, Young Adult
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